G2 Children Research Articles

BDNF, proBDNF and proBDNF/BDNF ratio with electroencephalographic abnormalities in children with attention deficit hyperactivity disorder: Possible relations to cognition and severity.

Attention deficit hyperactivity disorder (ADHD) with and without subclinical epileptogenic discharges (SED) have been suggested to negatively affect cognitive abilities of children with ADHD. The role of brain-derived neurotrophic factor (BDNF) and its precursor proBDNF in ADHD is in need of being investigated. The aims were to evaluate the levels of serum BDNF, proBDNF and the proBDNF/BDNF ratio in addition to the potential impacts of SED on the children's cognitive abilities and the severity of ADHD. The included participants with ADHD were 30 children with normal electroencephalogram (EEG) (G1) and 30 children with SED (G2), together with 30 healthy children (G3). The cognitive abilities and severity of the disorder were evaluated. The biochemical measures were determined by ELISA. The presence of coexisting SED and nocturnal enuresis has led to a deleterious effect on cognitive processes but not on the severity. The focal epileptogenic discharge was the most common among children in G2. The levels of BDNF in Groups 1 and 2 were less than those in G3. The higher proBDNF/BDNF ratio could be related to the low BDNF levels rather than high proBDNF levels. The findings of this study highlight the importance of investigating the presence of SED and nocturnal enuresis in children with ADHD. Targeting strengthening of cognitive abilities in children with coexisting ADHD and SED is advised. The role of proBDNF in the pathophysiology of ADHD needs further investigation.

Does adolescent academic achievement predict future parenting?

AbstractThe effects of academic achievement may extend beyond economic success to influence social functioning, including future parenting. To evaluate whether adolescent academic achievement forecasts future parenting (both positive and negative) and the family home environment of parents. We used prospectively gathered intergenerational data from a population‐based birth cohort born in 1972/1973 in Dunedin, New Zealand, including data from Generation 1 (parents of the birth cohort), the birth cohort (Generation 2; G2), and G2's children (Generation 3). Adolescent academic achievement in G2 was used to predict observed and reported parenting outcomes when offspring (G3) were aged 3 years after controlling for a range of covariates, including G2's adolescent wellbeing, early childhood socioeconomic status (collected from G1), and G2's age at child's birth. We also evaluated 2‐way interactions between academic achievement and G2 parent sex, G3 child behaviour, and G2 adolescent wellbeing. Greater G2 academic achievement, net of controls, predicted more positive and less negative parenting (for mothers only), and a more positive home environment. For the home environment outcome, the effect of adolescent academic achievement was moderated by wellbeing. Adolescent academic achievement may positively influence parenting behaviour and the quality of the home environment.

СОВРЕМЕННЫЕ ВОЗМОЖНОСТИ ЛЕЧЕБНОГО ПИТАНИЯ ПАЦИЕНТОВ С ДЕТСКИМ ЦЕРЕБРАЛЬНЫМ ПАРАЛИЧОМ ПРИ НАРУШЕНИЯХ НУТРИТИВНОГО СТАТУСА

With the purpose of successful rehabilitation, reduction of concomitant diseases, improvement of nutritional status and the quality of life of patients with cerebral palsy (CP) it is necessary to develop therapeutic nutrition technology, which would include methods for nutritional status assessment, choosing of enteral nutrition formulas, methods of their delivery and the duration of nutritional support. The purpose of this research was to substantiate the nutritional support for patients with CP. Materials and methods used: 98 children aged 2 to 16 years and 9 months old (Me 5.7 y/o) with a spastic form of CP that had been admitted for examination, treatment and rehabilitation at the National Medical Research Center for Children’s Health (Moscow, Russia) were examined. Depending on the level of motor activity calculated with GMFCS, the participants were divided into two groups: G1 of 51 (52%) with severe motor impairment (GMFCS IV to V) and G2 of 47 (48%) with mild and moderate motor impairment (GMFCS I to III). Clinical and anamnestic data, information about the severity and the course of the disease, concomitant pathology were analyzed as well as the anthropometric data (Z-scores: weight/age, height/age, BMI/age) using the WHO AnthroPlus application (2009 revision). EDACS survey had also been carried out. Results: Patients with severe motor impairments were significantly more likely to have problems associated with food intake, such as: prolonged feeding (over 30 minutes), predominance of semi-liquid and pureed food in the diet as well as frequent choking, vomiting, wheezing and coughing during the feeding process. All patients in this group needed external assistance in feeding. 75% had respiratory and 72% had gastrointestinal complications. Severe impairments (EDACS IV to V) characterized by significant restrictions on food safety were identified in 24 (23%) children, that met statistically significantly (p<0.001) more often in patients from G1 than from G2 (41% vs. 4%, respectively). Dietary analysis children with CP had showed that the quality and quantity of food consumed were monotonous and deficient. Consumption of pasta, cereals, and baking was 1.5 times higher than recommended whilst vegetables, fruits and healthy dairy products were reduced by 3 and 1.8 times, respectively, on the contrary. The WHO recommendations for children on the mandatory daily intake of 3 to 4 servings of various vegetables and fruits were not followed: in the majority (80%) of cases they’ve only had it once per day, and they even were completely absent in some cases. Nutritional assessment revealed that patients with severe movement disorders, regardless of the gender and nutritional status, had significant deficiencies in energy and protein intake. All studied anthropometric indicators in G1 patients were significantly (p<0.005) lower compared to G2 children. Prevalence of undernutrition was 72% and 32% (p<0.001), respectively. Individual nutritional program was developed for each and every studied patient with identified malnutrition and oropharyngeal dysphagia, followed by its clinical effectiveness assessment. Conclusion: enteral nutritional support with specialized formulas based on both whole and hydrolyzed proteins using the sipping/gastrostomy method, as well as with the use of a food and liquids thickeners, proved to be highly effective in the treatment and rehabilitation of CP children. Indicators characterizing food intake (time taken for feeding, frequency of choking records during meals, episodes of vomiting and regurgitation) have improved as well as the anthropometric indicators improved accordingly.

NT-proBNP as a Potential Marker of Cardiovascular Damage in Children with Chronic Kidney Disease.

Assessing cardiovascular disease (CVD) in children with chronic kidney disease (CKD) is difficult. Great expectations have been associated with biomarkers, including the N-terminal pro-brain natriuretic peptide (NT-proBNP). This study aimed to determine the correlation between NT-proBNP and cardiovascular complications in children with CKD. Serum NT-proBNP, arterial stiffness, common carotid artery intima-media thickness (cIMT), echocardiographic (ECHO) parameters (including tissue Doppler imaging), and biochemical and clinical data were analyzed in 38 pediatric patients with CKD (21 boys, 12.2 ± 4.2 years). Mean NT-proBNP in CKD patients was 1068.1 ± 4630 pg/mL. NT-proBNP above the norm (125 pg/mL) was found in 16 (42.1%) subjects. NT-proBNP correlated with glomerular filtration rate (GFR) (r = −0.423, p = 0.008), and was significantly higher in CKD G5 (glomerular filtration rate grade) patients compared to CKD G2, G3, and G4 children (p = 0.010, p = 0.004, and p = 0.018, respectively). Moreover, NT-proBNP correlated positively with augmentation index (AP/PP: r = 0.451, p = 0.018, P2/P: r = 0.460, p = 0.016), cIMT (r = 0.504, p = 0.020), and E/E’ in ECHO (r = 0.400, p = 0.032). In multivariate analysis, logNT-proBNP was the only significant predictor of cIMT Z-score (beta = 0.402, 95CI (0.082–0.721), p = 0.014) and P2/P1 (beta = 0.130, 95CI (0.082–0.721), p = 0.014). Conclusions: NT-proBNP may serve as a possible marker of thickening of the carotid artery wall in pediatric patients with CKD. The final role of NT-proBNP as a biomarker of arterial damage, left ventricular hypertrophy, or cardiac diastolic dysfunction in CKD children needs confirmation in prospective studies.

Major depression, temperament, and social support as psychosocial mechanisms of the intergenerational transmission of parenting styles.

In this three-generation longitudinal study of familial depression, we investigated the continuity of parenting styles, and major depressive disorder (MDD), temperament, and social support during childrearing as potential mechanisms. Each generation independently completed the Parental Bonding Instrument (PBI), measuring individuals' experiences of care and overprotection received from parents during childhood. MDD was assessed prospectively, up to 38 years, using the semi-structured Schedule for Affective Disorders and Schizophrenia (SADS). Social support and temperament were assessed using the Social Adjustment Scale - Self-Report (SAS-SR) and Dimensions of Temperament Scales - Revised, respectively. We first assessed transmission of parenting styles in the generation 1 to generation 2 cycle (G1→G2), including 133 G1 and their 229 G2 children (367 pairs), and found continuity of both care and overprotection. G1 MDD accounted for the association between G1→G2 experiences of care, and G1 social support and temperament moderated the transmission of overprotection. The findings were largely similar when examining these psychosocial mechanisms in 111 G2 and their spouses (G2+S) and their 136 children (G3) (a total of 223 pairs). Finally, in a subsample of families with three successive generations (G1→G2→G3), G2 experiences of overprotection accounted for the association between G1→G3 experiences of overprotection. The results of this study highlight the roles of MDD, temperament, and social support in the intergenerational continuity of parenting, which should be considered in interventions to "break the cycle" of poor parenting practices across generations.

How do grandparents' and parents' educational attainments influence parents' educational expectations for children?

Highly educated parents hold high educational expectations for their children, which influence children's motivation and achievement in school. However, it is unclear whether grandparents' (G1) education influences parents' (G2) expectations for children (G3) independently of, or in interaction with, parents' own education. We address this question using data from 477 families in the US Youth Development Study, which has followed a cohort of young people from adolescence through adulthood. Using mixed models to account for shared characteristics of children in the same family, our results demonstrate both main and interaction effects. First, they indicate that grandparents influence parents' expectations for their children directly. Grandparents' income and the educational expectations they held for their G2 children when they were in high school predict the G2 parents' expectations for their own children, even after controlling G2 college attendance. G1 college attendance does not directly affect G2 expectations for G3 after accounting for other relevant family characteristics. However, G1 college attendance moderates the effect of G2 college attendance on their expectations for G3. If G1 did not attend college, G2 college attendance does not significantly heighten their expectations for G3. But G2 college attendance does significantly boost their expectations for G3 if G1 also attended college. We partially replicate these findings using nationally representative data from the US National Longitudinal Survey of Youth - Child and Young Adult cohort. This study highlights the need to expand the scope of status attainment research beyond the parent-child dyad to examine the influence of prior generations.

The Avon Longitudinal Study of Parents and Children - A resource for COVID-19 research: Generation 2 questionnaire data capture May-July 2020.

The Avon Longitudinal Study of Parents and Children (ALSPAC) is a prospective population-based cohort study which recruited pregnant women in 1990-1992 from the Bristol area (UK). ALSPAC has followed these women, their partners (Generation 0; G0) and their offspring (Generation 1; G1) ever since. From 2012, ALSPAC has identified G1 participants who were pregnant (or their partner was) or had become parents, and enrolled them, their partners, and children in the ALSPAC-Generation 2 (ALSPAC-G2) study, providing a unique multi-generational cohort. At present, approximately 1,100 G2 children (excluding those in utero) from 810 G1 participants have been enrolled. In response to the COVID-19 pandemic, ALSPAC rapidly deployed two online questionnaires; one during the initial lockdown phase in 2020 (9 th April-15 th May), and another when national lockdown restrictions were eased (26 th May-5 th July). As part of this second questionnaire, G1 parents completed a questionnaire about each of their G2 children. This covered: parental reports of children's feelings and behaviour since lockdown, school attendance, contact patterns, and health. A total of 289 G1 participants completed this questionnaire on behalf of 411 G2 children. This COVID-19 G2 questionnaire data can be combined with pre-pandemic ALSPAC-G2 data, plus ALSPAC-G1 and -G0 data, to understand how children's health and behaviour has been affected by the pandemic and its management. Data from this questionnaire will be complemented with linkage to health records and results of biological testing as they become available. Prospective studies are necessary to understand the impact of this pandemic on children's health and development, yet few relevant studies exist; this resource will aid these efforts. Data has been released as: 1) a freely-available dataset containing participant responses with key sociodemographic variables; and 2) an ALSPAC-held dataset which can be combined with existing ALSPAC data, enabling bespoke research across all areas supported by the study.

Grandmothers' endocrine disruption during pregnancy, low birth weight, and preterm birth in third generation.

Diethylstilbestrol (DES) is an endocrine-disrupting pharmaceutical prescribed to pregnant women to prevent pregnancy complications between the 1940s and 1970s. Although DES has been shown in animal studies to have multigenerational effects, only two studies have investigated potential multigenerational effects in humans on preterm birth (PTB), and none on low birthweight (LBW)-major determinants of later life health. Nurses' Health Study (NHS) II participants (G1; born 1946-64) reported their mothers' (G0) use of DES while pregnant with them. We used cluster-weighted generalized estimating equations to estimate odds ratios (OR) and 95% confidence intervals (CI) for risk of LBW and PTB among the grandchildren by grandmother use of DES. G1 birthweight and gestational age were considered to explore confounding by indication. Among 54334 G0-G1/grandmother-mother pairs, 973 (1.8%) G0 used DES during pregnancy with G1. Of the 128275 G2 children, 4369 (3.4%) were LBW and 7976 (6.2%) premature. Grandmother (G0) use of DES during pregnancy was associated with an increased risk of G2 LBW [adjusted OR (aOR) = 3.09; 95% CI: 2.57, 3.72], that was reduced when restricted to term births (aOR = 1.59; 95% CI: 1.08, 2.36). The aOR for PTB was 2.88 (95% CI: 2.46, 3.37). Results were essentially unchanged when G1 birthweight and gestational age were included in the model, as well as after adjusting for other potential intermediate variables, such as G2 pregnancy-related factors. Grandmother use of DES during pregnancy is associated with an increased risk of LBW, predominantly through an increased risk of PTB. Results when considering G1 birth outcomes suggest this does not result from confounding by indication.

The Avon Longitudinal Study of Parents and Children - A resource for COVID-19 research: Generation 2 questionnaire data capture May-July 2020.

The Avon Longitudinal Study of Parents and Children (ALSPAC) is a prospective population-based cohort study which recruited pregnant women in 1990-1992 from the Bristol area (UK). ALSPAC has followed these women, their partners (Generation 0; G0) and their offspring (Generation 1; G1) ever since. From 2012, ALSPAC has identified G1 participants who were pregnant (or their partner was) or had become parents, and enrolled them, their partners, and children in the ALSPAC-Generation 2 (ALSPAC-G2) study, providing a unique multi-generational cohort. At present, approximately 1,100 G2 children (excluding those in utero) from 810 G1 participants have been enrolled. In response to the COVID-19 pandemic, ALSPAC rapidly deployed two online questionnaires; one during the initial lockdown phase in 2020 (9 th April-15 th May), and another when national lockdown restrictions were eased (26 th May-5 th July). As part of this second questionnaire, G1 parents completed a questionnaire about each of their G2 children. This covered: parental reports of children's feelings and behaviour since lockdown, school attendance, contact patterns, and health. A total of 289 G1 participants completed this questionnaire on behalf of 411 G2 children. This COVID-19 G2 questionnaire data can be combined with pre-pandemic ALSPAC-G2 data, plus ALSPAC-G1 and -G0 data, to understand how children's health and behaviour has been affected by the pandemic and its management. Data from this questionnaire will be complemented with linkage to health records and results of biological testing as they become available. Prospective studies are necessary to understand the impact of this pandemic on children's health and development, yet few relevant studies exist; this resource will aid these efforts. Data has been released as: 1) a freely-available dataset containing participant responses with key sociodemographic variables; and 2) an ALSPAC-held dataset which can be combined with existing ALSPAC data, enabling bespoke research across all areas supported by the study.

Baseline features and management in adult and pediatric clinically suspected and biopsy-proven myocarditis in the cardiomyopathy and myocarditis long-term EORP registry

Abstract Background The Myocarditis section of the EORP Cardiomyopathy and Myocarditis Long-term Registry is a prospective, observational, multinational registry of adult and pediatric patients enrolled using the ESC 2013 diagnostic criteria of clinically suspected (CS) or biopsy-proven (BP) myocarditis (myoc). Purpose i) To obtain a real-world snapshot of features and management of myoc; ii) to assess features at presentation in CS and in BP myoc and by age. Methods 581 patients (68% male), 493 adults, aged 34.9 (SD 18.5) years, and 88 children, aged 8.1 (SD 5.2) years, were divided into 3 groups (G): G1 (n=234, 40%), CS myoc plus cardiac magnetic resonance (CMR) confirmed; G2 (n=222, 38,2%), BP myoc; G3 (n=125, 21.5%), CS myoc, no or normal or inconclusive CMR. Baseline features, procedures, medications were analysed in the total population, in adults vs children, and among G. Results In all patients: pseudo-infarct presentation with normal coronary arteries is common (58%), as is heart failure (HF) with or without chest pain and troponin release (58%), followed by arrhythmia (41.9%). In children new-onset HF is more common than in adults (29/32, 90% vs 90/190, 47%, p=0.001). In both adult and pediatric G2 BP myoc, HF and arrhythmia were more common than in CS myoc. Left and right ventricular (RV) echocardiography and CMR function indexes and troponins were lower, NT-pro BNP was higher in G2 BP myoc vs G1 and G3 CS myoc. On CMR oedema and/or Late Gadolinium Enhancement (LGE) were found in 57.4% of adult and in 31.3% of paediatric G2 BP myoc. Endomyocardial biopsy (EMB) was obtained in a similar proportion in children (31/88, 35.2%) and adults (185/493, 37.5%, p=NS), ventricular assist devices were more commonly implanted in G2 children (8/32, 25%) than in G2 adults (4/190, 2.1%, p=0.001), ICD tended to be less common in G2 children (2/32, 6.3%) than in G2 adults (48/190, 25%, p=0.07). In all patients EMB, mainly RV (75.8%), had a low complication rate (4.7%), similar in adults vs children, with no procedure-related death. Histology findings were: lymphocitic myoc (78.9%), giant cell (10.9%), sarcoid (6.9%), non specific (16%). Viral genome was found in 44% of patients (most common PVB19, 21.7%, HHV6, 9.5%). In all patients HF and antiarrhytmic drugs were more frequently used in G2, antivirals in a patient minority, steroids in 24.7%, immunosuppression (IS) in 22.6%. In children steroids or IS were given regardless of G, in adults mainly to G2 BP myoc patients, in keeping with the ESC 2013 expert reco's. Conclusions EMB is safe in children and adults and is still the diagnostic gold standard, since CMR failed to identify myoc in a high proportion of G2 BP patients. Etiology-directed therapy was used in a minority of G2 cases, and/or regardless of etiology, thus there is room for improved management. G2 BP patients were older, sicker, had worse biventricular function, more medications and ICDs; follow-up may show their worse outcome. Funding Acknowledgement Type of funding source: None

Written narrative of students with and without difficulty in syntactic awareness

Introduction: Syntactic awareness is a metalinguistic ability defined as the child’s ability to reflect on formal processes relating to the organization of words in sentences and to manipulate them. This skill is still little explored in the context of school learning, and its importance in the school learning process of Portuguese-speaking children is poorly described. Objective: To compare written narrative between children with and without difficulty in syntactic awareness. Methods: The study was conducted on 60 children (mean age 9.4 years; SD: 0.9) enrolled in the 4th and 5th years of elementary school in a municipal school. The subjects were divided into two groups according to their performance in the task of syntactic awareness - G1 (children with medium/high performance in syntactic awareness) and G2 (lower performance). After the assessment of syntactic awareness each child elaborated a written narrative text based on a stimulus figure. This text was analyzed by judges in terms of spelling, grammatical errors, use of grammatical classes, and content. The Student t-test (α = 0.05) was used to compare the groups. Results: G2 children showed altered handwriting; greater occurrence of spelling mistakes, mainly of irregular phonographic relation type; oral support and difficulty with nasal markers; short texts with preference for the use of nouns and verbs, as well as difficulties with text structuring, use of punctuation and vocabulary, while G1 used more verbs and pronouns instead of nouns. Conclusions: Children with adequate syntactic awareness were able to elaborate written narratives with greater competence, demonstrating acquisition of orthographic aspects and development of textual coherence.

Concordance between child’s and parents’- reported Health-related quality of life and overweight

Abstract Background Health-related quality of life (HRQoL) of children is an important health outcome which has frequently been investigated regarding children's chronicle illnesses using parents proxy-reported HRQoL. Obesity is an increasingly frequent condition in children, for which the evidence about perceived quality of life is lacking. The aim of our study is to examine the concordance between child's and parents'- reported HRQoL according to children's weight status. Methods A cross-sectional study was conducted in 2019 among 128 children, aged 6-10, recruited in a primary school of Imola (Italy). Children were divided in Group1 (G1: normal-underweight) and Group2 (G2: overweight-obese) using the International Obesity Task Force cut points. HRQoL was assessed using the Italian version 4.0 of Paediatric Quality of Life (PedsQL) questionnaire. We obtained self-reported children's HRQoL total score and the parents' perceived children's HRQoL total score. Each score had two subscales: one for physical health and one for emotional, social and school functioning. Results In G1 there were 86 children and in G2 42. The correlation between the children's and parents' HRQoL scores is low in G1 (physical health: 0.24; emotional, social and school functioning: 0.15). Children in G2 and their and parents' perception of physical health are poorly correlated (r=-0.09) and those of emotional, social and school functioning are well correlated (r = 0.43).We observed that in case of discordant HRQoL results, parents usually overestimate their children's HRQoL. Conclusions Correlation between the children's and parents' HRQoL scores is low in G1. In G2 children's and parents' perception are concordant for emotional, social and school functioning and unrelated for physical health. It would be useful to investigate whether these results depend from lack of communication between parents and children or lack of parents' awareness of health-related problems with obesity. Key messages Parents and children have a discordant perception of physical health quality of life. Further studies should investigate the reasons why these results are discordant.

Trajectories of childhood anxiety disorders in two generations at high risk.

The course of anxiety disorders during childhood is heterogeneous. In two generations at high or low risk, we described the course of childhood anxiety disorders and evaluated whether parent or grandparent major depressive disorder (MDD) predicted a persistent anxiety course. We utilized a multigenerational study (1982-2015), following children (second generation, G2) and grandchildren (third generation, G3) of generation 1 (G1) with either moderate/severe MDD or no psychiatric illness. Psychiatric diagnoses were based on diagnostic interviews. Using group-based trajectory models, we identified clusters of children with similar anxiety disorder trajectories (age 0-17). We identified three primary trajectories in G2 (N = 275) and G3 (N = 118) cohorts: "no/low anxiety disorder" during childhood (G2 = 66%; G3 = 53%), "nonpersistent" with anxiety during part of childhood (G2 = 16%; G3 = 21%), and "persistent" (G2 = 18%; G3 = 25%). Childhood mood disorders and substance use disorders tended to be more prevalent in children in the persistent anxiety trajectory. In G2 children, parent MDD was associated with an increased likelihood of being in the persistent (84%) or nonpersistent trajectory (82%) versus no/low anxiety trajectory (62%). In G3 children, grandparent MDD, but not parent, was associated with an increased likelihood of being in the persistent (83%) versus nonpersistent (48%) and no/low anxiety (51%) trajectories. Anxiety trajectories move beyond what is captured under binary, single time-point measures. Parent or grandparent history of moderate/severe MDD may offer value in predicting child anxiety disorder course, which could help clinicians and caregivers identify children needing increased attention and screening for other psychiatric conditions.

The role of oxytocinergic genes in the intergenerational transmission of parent–child relationship qualities

Parenting qualities are known to transmit across generations, but less is known about genetic processes that may modify how strongly parenting quality carries across generations. We examined in prospective data whether oxytocinergic genes of offspring moderate the intergenerational transmission of warm and accepting parent–child relationship qualities. The sample comprised 1167 Finnish parents (G2, 62% female) and their mothers (G1). At the study baseline, G1 mothers (Mage = 38) reported parent–child relationship qualities towards G2 children (age range 3–18). After 28–34 years, G2 offspring reported parent–child relationship qualities towards their own children using the same questionnaire. A cumulative genetic score was computed for G2 by summing up previously identified four alleles associated with non-optimal parenting or social impairments across OXTR (rs1042778, rs2254298, rs53576) and CD38 (rs3796863) genes. Results indicated no interaction effects of G2 cumulative genetic score on the transmission of parent–child relationship qualities. Among single polymorphisms in OXTR, the interaction effects of rs53576 and rs1042778 were found. G1 maternal emotional warmth was associated with higher G2 emotional warmth among G2 participants with the OXTR rs53576 AA/AG genotype, but not among those with the GG genotype. G1 maternal acceptance was associated with higher G2 acceptance among those G2 participants with the OXTR rs1042778 GG/GT genotype, but not among those with the TT genotype. Oxytocinergic genes may influence sensitivity to quality of parent–child relationship, although this needs replication in future studies.

The impact of motivational therapy in the management of enuretic children.

The aim of this study is to determine the impact of a motivational therapy (MT) on the outcomes for individuals diagnosed with nocturnal enuresis (NE). We enrolled 158 patients with NE referred to the Service of Pediatrics, Campus Bio-Medico University Hospital of Rome, from January 2013 to September 2017. Of these, 21 were excluded because they didn't meet the inclusion criteria. The study was carried out in compliance with the Helsinki Declaration. A hundred and thirty seven enuretic patients [100 (72.9%) male and 37 (27.1%)] female patients with a median age of 8.8 years were included in the study. The patients were assigned to receive pharmacological therapy with desmopressin (dDAVP) (G1) (n=51), MT (G2) (n=33) and both of them (G3) (n=53). The three groups were homogeneous, with no significant differences in gender, age and family history of NE. In G1, 30/51 (58.82%) children achieved response vs. 1/33 (3.0%) children in G2 vs. 35/53 (66.04%) children in G3. About these results, The differences between G2 vs. G1 (p<0.01) and vs. G3 (p<0.01) were statistically significant while the difference between G1 vs G3 was not statistically significant (p=0.45). Our study underlines the importance of MT in the management of NE and highlights the safety of treatment and the positive effect of MT on the compliance and the adherence to pharmacological therapy. Considering the importance of the impact of such evidence on children's lifestyle, we expect that further study with a larger sample size may confirm our hypothesis.

O efeito da idade em uma tarefa de identificação das vogais tônicas do Português Brasileiro

RESUMO Objetivo: Investigar o efeito da idade na identificação das vogais tônicas do Português Brasileiro em crianças. Métodos: Avaliou-se, com o uso do software Perception Evaluation Auditive &amp; Visuelle (PERCEVAL), o desempenho perceptivo-auditivo de 155 crianças, entre 5 e 9 anos de idade (divididas em 2 grupos, G1 e G2), em uma tarefa de identificação das vogais tônicas do Português Brasileiro. Foram apresentados os estímulos acústico e visual, solicitando-se à criança a escolha da gravura correspondente à palavra apresentada auditivamente, dentre duas possibilidades de imagens dispostas na tela do computador. O tempo de apresentação dos estímulos e de reação das crianças foi computado, automaticamente, pelo software. Resultados: O grupo de crianças mais velhas (G2) apresentou melhor acurácia perceptivo-auditiva, quando comparada à acurácia do grupo de crianças menores (G1). Quanto ao tempo de reação, o G1 sempre apresentou um tempo de reação superior ao das crianças do G2, tanto para os acertos, quanto para os erros. Quanto ao padrão de erros, de um modo geral, os grupos não se diferenciaram. A análise da correlação entre idade e acurácia mostrou que as crianças do G1 apresentaram correlação positiva com a idade. No entanto, isso não ocorreu para as crianças do G2. Conclusão: A habilidade perceptivo-auditiva, no que diz respeito à identificação de contrastes vocálicos, parece ocorrer de forma gradativa e se estabilizar aos 9 anos de idade.

Aspectos da fluência da fala em crianças com distúrbio específico de linguagem

Objetivo Avaliar aspectos específicos da fluência da fala em crianças com DEL, quanto à tipologia de rupturas comuns e velocidade de fala (em palavras e sílabas por minuto), considerando as diferentes faixas etárias. Métodos Participaram 50 crianças de ambos os gêneros, na faixa etária de 3 a 7 anos, com QI não verbal e limiares auditivos dentro da normalidade e ausência de gagueira. As crianças foram divididas em dois grupos: G1 (DEL), com 25 crianças (sete meninas e 18 meninos, com idades entre 3 e 7 anos) e G2 (desenvolvimento típico), com 25 crianças pareadas em idade e gênero ao GI. Foi apresentada uma figura à criança e solicitado que falasse o que quisesse sobre ela. Cada amostra de fala foi composta por 200 sílabas fluentes ou 100 palavras fluentes. Resultados A análise intergrupos demonstrou que crianças de 3 e 4 anos do G1 apresentaram menor velocidade de fala que seus pares em desenvolvimento típico. Na análise intragrupos, no que se refere à tipologia de rupturas, o G1 não apresentou diferenças em nenhuma das faixas etárias. Já o G2, para as faixas etárias de 4 e 5 anos, a hesitação foi mais frequente e aos 6 e 7 anos, a hesitação e a repetição de palavras se diferenciaram das demais tipologias. Conclusão Crianças com suspeita de DEL nas idades de 3 e 4 anos, aqui estudadas, apresentaram redução da produção de palavras e sílabas. As rupturas de fala, do tipo hesitação, foram recursos usados pelas crianças com desenvolvimento típico de todas as faixas etárias, o que não ocorreu nas crianças com DEL.

Effectiveness of an oral health program for mothers and their infants

The baby oral health program (bOHP) provides pregnant women and their future babies with oral care. To assess the bOHP effectiveness by comparing caries prevalence in infants enrolled and not enrolled in the oral health program (OHP). Mothers who had been invited to participate in the bOHP from 2006 to 2009 were contacted. Two groups were formed: 87 pairs of mothers and infants who effectively participated in the OHP (G1) and 107 pairs who did not (G2). Mothers and infants were given a dental examination. Socio-economic status (SES) and education level (EL) questionnaires were completed. t-tests and multivariate logistic regression were used in analyzing data. Statistically significant differences were observed in the mean age of mothers (G1=33.8years; G2=35.6years; P=0.015) and mean decayed, missed and filled surface (DMFS) score (G1=24.71; G2=32.58; P<0.001), not in SES (P=0.758) and EL (P=0.109). Mean age and mean dmfs scores of G1 and G2 children were 4.2 and 4.4years (P=0.068), and 0.25 and 4.12 (P<0.001), respectively. The odds ratio (OR) for children in G2 to develop dentine lesions, as opposed to those in G1, was 48.56. The bOHP was effective in preventing caries in infants enrolled in the program.

Contrastes e contrastes encobertos na produção da fala de crianças

Speech acoustics. To acoustically analyze the substitution between /t/ and /k/ in the speech production of children with typical and deviant acquisition process in order to identify and quantify the presence of covert contrast. The experiment involved the repetition of words that combined /t/ and /k/ with /a/ and /u/ in stressed position. Participants were 9 children divided in three groups: children in the acquisition process of the phonological contrast (G1); children with phonological disorder (G2); and children with typical productions (G3). The speech productions were analyzed and edited using software Praat. The acoustic parameters adopted were: burst spectral characteristics; CV transition and durational characteristics. Duration parameters were analyzed by Friedman ANOVA while the other parameters were analyzed using two-way ANOVA and Hierarchical Linear Modeling. The adopted statistical significance level was of 0.05. Acoustic analysis indicated the presence of covert contrast in the productions of children in G1 and G2 (80% and 57.14% of substitutions respectively). In addition, acoustic analysis revealed differences in how well the children differentiated the two occlusives and which acoustic parameters were used to differentiate them. A lot of the substitutions presented in the speech of children in typical and deviant acquisition process are in fact covert contrasts. Moreover, the acoustic analyses allowed the detection of differences in the fine phonetic detail of children's speech production.

Does finger training increase young children's numerical performance?

Butterworth (1999) suggested that fingers are important in representing numerosities. Furthermore, scores on a finger gnosis test are a better predictor of numerical performance up to 3 years later than intellectual measures (Marinthe et al., 2001; Noël, 2005). We hypothesised that training in finger differentiation would increase finger gnosis and might also improve numerical performance. Accordingly, 47 first-grade children were selected and divided into 3 groups: children with poor finger gnosis who followed the finger-differentiation training programme (G1), a control-intervention who were trained in story comprehension (G2), and a group with high finger gnosis scores who just continued with normal school lessons (G3). The finger training consisted of 2 weekly sessions of half an hour each, for 8 weeks. Before the training period, children in G3 performed better in finger gnosis and enumeration than children in the two other groups. After the training period this pattern remained for the children in G2 and G3, but the children in G1 were significantly better than those in G2 at finger gnosis, representation of numerosities with fingers, and quantification tasks; they also tended to be better at the processing of Arabic digits. These results indicate that improving finger gnosis in young children is possible and that it can provide a useful support to learning mathematics. Such an approach could be particularly appropriate for children with a developmental Gerstmann syndrome. Theoretically, these results are important because they suggest a functional link between finger gnosis and number skills.